THURSDAYS 9|8c

Brief Reactive Psychosis

  • By Meg Marinis, Director of Medical Research
Brief Reactive Psychosis
Do you feel more at ease now that you've learned what happened to our plane crash victims since they were rescued? Or do you feel more anxious? I feel anxious. And nervous. Anxiously nervous? Our people suffered a horrible tragedy, and we're only at the beginning of their road to recovery. And I'm not just worried about their physical injuries – I mean, yes, I'm extremely stressed out about the fact that Arizona now only has one leg, and Derek's hand might never be perfect again, but… 

… Cristina threw a vase. AT interns.

Cristina suffered from brief reactive psychosis (also called brief psychotic disorder) -- a short-term illness with psychiatric symptoms.

The disorder often occurs after a stressful event, such as a traumatic accident or loss of a loved one. The behavior can appear to come on suddenly, with or without the person's awareness, and it is soon followed by a return to normal function. Other forms of the disorder can happen without an obvious stressor or following the birth of a child.

Studies suggest that genetics may play a role – it seems to be more common in people who have family members with mood disorders (such as depression or bipolar disorder). Another theory points to poor coping skills as a contributing cause; people may develop the disorder as a defensive reaction to a trauma or frightening situation. Regardless of the various theories, the disorder is considered rare and generally affects those in early adulthood (20s and 30s).

Symptoms can last from one day up to one month – They include:

• Hallucinations.
• Delusions.
• Thought disturbances.
• Loss of insight.
• Strange speech or language.
• Unusual behavior and dress.
• Change in eating or sleeping habits, energy level, or weight.
• Disorientation or confusion.
• Memory problems.

No specific laboratory test can diagnose brief reactive psychosis.

If a patient presents with the described symptoms, a doctor will perform a complete medical history and physical exam. Tests and imaging may be run, but doctors use these tools solely to rule out physical illness as the cause. If the tests reveal nothing, the doctor will then refer the patient to a mental health professional for further evaluation and treatment.

Treatment of brief reactive psychosis focuses mainly on counseling and anti-psychotic medication. Prescribed drugs may help decrease or stop the psychotic symptoms, which will typically dissipate after a month. Reports state that the medication is not addictive and does not come with serious withdrawal effects (one mild effect might be "feeling shaky").

Along with anti-psychotics, the patient may be given benzodiazepines – common sedatives used to treat agitation and sleep problems. These medications work to lessen anxiety, induce sleepiness, and relax the muscles. However, unlike the anti-psychotics, benzodiazepines can be addictive, so doctors try to only prescribe them for up to two weeks.

Some patients, like Cristina, may require a brief hospitalization due to the severity of symptoms or the possibility of being a risk to others or oneself. However, most patients diagnosed go on to have a full recovery and return to function after one month. In rare cases, patients have recurrent episodes, but that type of presentation may indicate other underlying disorders.

For more information on brief reactive psychosis, please visit the following link:

http://www.nlm.nih.gov/medlineplus/ency/article/001529.htm
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